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What Causes Panic Attacks After Taking Nortriptyine?

Posted on Fri, 2 May 2014

Question: I take(2) 25 milligram capsules of Nortriplyine. The doctor has told me to take 3 capsules which would make it 75. When I take 75 miligrams I get panicky, scared and have a horrible day. When I just take 50 after a few days I feel a little down. What can I do? I also take (3) 300 miligrams of Gapapentin, Simvastatin, ( cholorestol) and 5 miligrams of Ambien to sleep. What can I do to feel good on the antidepressant without taking 3 of them?

Answered by Dr. Manisha Gopal (1 hour later)

Brief Answer: try divided doses or change the drug Detailed Answer: Hello and welcome to.hcm! You are taking nortryptaline and there is insufficient reponse at 50mg and increased anxiety with 75mg. Many people on nortryptyline have this problem at high doses - they develop anxiety inspite of getting rid of it. In.such a situation there are two options- 1. take 50mg at night and 25mg in morning. 2. or, better approach is to change the molecule to a better class of antianxiety. Drugs like venalafaxine, patoxetine or sertraline are in any ways better than nortriptyline. So, try out taking the divided doses of nortriptyline first; if that works- continue and enjoy life. If not & there is still some anxiety: change the drug. I hope the reply helps Dr. Manisha Gopal MD Psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Gopal (1 hour later)

I had been taking Paxil for 14 years and tolerated it well, then tragedy struck and 4 members of my family died. Dealing with the grief and other issues made it so Paxil for some reason was not effective anymore. I have been trying a number of other drugs since then like Wellbutrin, Lexapro, abilify, Cymbalta, and the new one Fetzima. These drugs didn't seem to work and Fetzima was fine at (2) doses of it them the sameple paket went to 40 and I was so nervous I couldn't stand it. I tried Zoloft in the past and it made me vey nervous. Effexor was great at 37.5 miligrams but when the doctor rasied it to 75 I was panicky, stressed and frlt horrible. That is why the doctor put me on notriptyline. Maybe the problem is to split the dose like you said on notrtyline first taking 25 in the morning and 50 at night. Maybe Effexor and Fetzima would have worked as well my splitting them. Yesterday I was so stressed panic attacks, nervous and etc. I would do nothing but cry and use some clonasopam to calm down. Was so scared as nevrous, never want to go through that again. I apprpeciate your answer maybe splitting should be the way to go.

Answered by Dr. Manisha Gopal (1 hour later)

Brief Answer: please try the following methods Detailed Answer: Hello, After reading opur reply I can see that you have been.through a difficult life..have seen a lot of things.. You are also a sensitive person both by body and mind and are prone to develop anxiety on even moderate doses. There are few more methods which may help you along with splitting of doses- 1. walk and jogging -20min two times a day 2. 3-4 servings of salad in a day ( what ever u like to take ) 3. a bowl of sprouts in morning 4. please stay away from tea or coffee, choclates and cold drinks...they increase nervous stimulation 5. try taking tab. etizolaam 0.5 mg in morning and in afternoon for two weeks..this will reduce anxiety fast. please try these methods religiously- they work wonders.. Wish you all the best! Dr. Manisha Gopal MD psychiatry

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manisha Gopal (2 hours later)

sounds like good advice I will have to follow it. Thanks for the excellent answers.

Answered by Dr. Manisha Gopal (3 hours later)

Brief Answer: learn deep relaxed breathing- pranayaam Detailed Answer: I hope the reply helps you. I would like to give few more changes before we end this query line: 1. As you are quite prone to develop side efects- you should start with 0.25mg of etizolam instead of 0.5mg. Once you feel.comfortable with the low dose you will be able.to increase it with confidence. 2. All kinds of exercises when done correctly are good for health. Surpassing them all is Pranayaam - an Indian yogic technique of breathing. You can search it on net and learn it. This reduces anxiety significantly (even when done alone). These exercises are good and specialy recommended for the ones who have difficulty taking medicine or are allergic to them. Wish you good luck! Dr. Manisha Gopal MD Psychiatry

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar